Putting the Cart Before the Horse

Danielle Toppin

Danielle Toppin offers suggestions to improve a pilot survey in the Caribbean that fell short of reaching a wide number of people in groups vulnerable to HIV.

In the development of HIV/AIDS policies and intervention programmes, one of the key challenges faced by planners is meeting the needs of "hidden," and by extension vulnerable, groups. In recognition of this, and faced with increases in the spread of HIV infection, alongside a paucity of reliable national data on behavioural trends, the member states of the Organisation of Eastern Caribbean States moved to conduct behavioural research on elusive and vulnerable populations. To this end, technical and financial assistance was secured from a number of agencies, with the Caribbean Epidemiology Centre (CAREC) spearheading the research.

This was the genesis of the Behavioural and HIV Seroprevalence Surveillance Surveys (BSS), which were piloted in two OECS member states—Antigua and Barbuda (A&B) and St. Vincent and the Grenadines (SVG), from November 2006-January 2007. Employing the Respondent Driven Sampling Method (RDS), a technique which has successfully been used in reaching "hidden" populations, the pilot study sought to reach a wide cross section of members of two particularly at risk groups—Men who have Sex with Men (MSM) and Female Sex Workers (FSW). The research took a two-pronged approach, investigating not only the prevalence of HIV, but also the attitudes and behaviours of members within the groups. Ultimately, the pilot study hoped not only to gauge HIV prevalence and risk behaviours among these two groups, but also to create a road map that would guide further efforts to create effective intervention policies and programmes, as well as prevention and care options throughout the OECS region.

However, at the close of the survey period, the pilot study had failed to meet its objective of reaching a wide number of respondents; in the case of A&B, interviews were secured with only 6 MSMs and 11 FSWs—numbers which contrast sharply with the projected sample sizes at the start of the study period (111 MSMs and 218 FSWs). Despite these low numbers however, unofficial reports suggest that a significant percentage of respondents tested positive for HIV, a reality that is increasingly alarming given the inability to reach the expected numbers of group members. It importantly raises the questions of "why did these groups remain inaccessible?" and "what can be done in the future to avoid such shortcomings?"

The issue of culture is one that is unquestionably present in answering the first question. The importation of the RDS methodology was done primarily on the basis of its success in other cultural contexts, without giving the necessary consideration to its applicability in the Caribbean, and more specifically in the sub-group of the OECS. Certain cultural facts were therefore not taken into consideration. The discrimination faced by these groups, which could hinder their willingness to self-identify as a member of these groups; the small size of the islands; the rates charged by FSWs, which often surpassed the monetary incentives offered for participation in the research; the nature of the relationships that exist within the groups … all of these concerns could have been integrated into the research.

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The need for cultural consideration is seen in the case of FSWs in the two pilot countries. In Antigua, sex work is indeed present, yet it is reportedly marked by a hostile and unstable climate in which FSWs may not form numerous relationships with other FSWs, who may be seen as competition. Such women would therefore be unable—or unwilling—to provide the wide reach required in the RDS referral system. In the case of SVG, one of the challenges faced was the weak network of FSWs, another cultural consideration that challenged the efficacy of the RDS methodology.

This raises another consideration. Even within the Caribbean it cannot be assumed that we are a one-dimensional people. Cultures vary from island to island, and even within islands. Research of such a delicate nature must take into account the ways in which the cultural climates vary within and across the islands. Such considerations have to take into account issues such as race, class, nation and sexuality, amongst others.

This leads me to suggesting one possible solution to the second question. In most countries, there are local level community workers whose understanding of these groups far surpasses that of researchers who often come from different territories or social backgrounds. Integrating such key persons into the research process could go a far way towards developing research that works the first time around. Value must be given to local knowledge at all stages of the research process. Too much valuable time is wasted when key players are left out. Given the increases in HIV infections and the lack of information about the prevalence of the disease, as well as the behaviours in vulnerable groups … that valuable time is some we just can't afford to waste.

Culture & Conversation Violence

Breaking Through the Fear: How One Woman Investigated the Life of Her Rapist

Ilana Masad

Ignorance is caused by fear, reporter Joanna Connors writes, and it is with this attitude that, 21 years after she was raped, she begins the process of trying to understand the man who raped her, the man she thought “would be the last human being [she] would see on this earth.”

She was fine. That’s what she told everyone, including herself. After filing a report with the Cleveland police and getting her rapist locked up, she was fine. Fine, fine, fine. Except she wasn’t.

In I Will Find You: A Reporter Investigates the Life of the Man Who Raped Her, reporter Joanna Connors realizes that she is most assuredly not fine during a college campus visit with her daughter.

Ignorance is caused by fear, Connors writes. And it is with this attitude that, 21 years after she was raped—she immediately reported her rape to the police, and her rapist was caught the next day—she begins the process of breaking through the fear to understand the man who raped her, the man she thought “would be the last human being [she] would see on this earth.” She had thought she was over it, but it wasn’t until breaking down during that college tour that she realized she was still afraid of her rapist and still terrified he would find her.

When Connors was 30, she went to a Case Western Reserve University theater where a rehearsal of a play that she was covering for her newspaper, Cleveland’s Plain Dealer, was taking place.

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A man inside the empty theater—the actors had left by the time Connors arrived—beckoned her inside, saying that he was working on the lights. Then, brandishing a sharpened pair of scissors, he threatened to kill her if she didn’t do what he said and spent more than an hour raping her.

The chapter detailing her rape is chilling, as she describes the various acts performed, the way she went along with what her rapist told her to do, coaxing him on, hoping to make the ordeal end more quickly. By describing specifics of her rape, Connors is confronting and stripping away the shame she experienced by showing the reader the cold, hard facts of what a rape can be like.

Her words demonstrate how a person who was raped becomes a survivor. Even in her dissociative state, she didn’t want to die there at the hands of a man she didn’t know. She managed to convince him to stop and leave, and he kissed her goodbye outside, as if what had just happened was completely, utterly normal. Maybe, for him, a man whom she says was smoking menthols and who had a tattoo on his arm with his own name on it—”DAVE”—it was.

Connors found an eerie irony in that she was raped on a college campus before such rapes were more widely discussed. In recent years, there has been a rise in awareness regarding the frequency of rapes at institutions of higher learning. There are now websites dedicated to explaining the statistics as well as documentaries like The Hunting Ground, which explores the sexual violence that happens on U.S. college campuses and how students are pushing back against institutional cover-ups and injustices. Since Connors’ experience, society has begun to more broadly understand the terms “rape” and “sexual assault,” and there has been more discussion about the rapes and sexual assaults that happen within existing relationships; eight out of ten rapes occur between people who know one another.

It’s perhaps less common these days to find discussions of the other kind of rape: the kind that we’re warned about when we’re young and told not to take candy from strangers, the kind that makes us automatically cross the street when a group of men we find threatening happens to be walking toward us, the kind that happens when a complete stranger attacks us. This was Connors’ experience.

I Will Find You takes the reader through two distinct processes. The first is Connors’ discovery that her rapist may have been a sexual-violence survivor in his own right. The second, which carries the narrative, is how Connors came to terms with how being raped by David Francis, the “DAVE”-tattooed man, separated her life into a “before” and an “after.”

Before the rape, she was a reporter who lived largely without fear. Connors explains that she went into the theater, where her rapist, a young Black man, was beckoning her, for one reason: “I could not allow myself to be the white woman who fears black men.”

But after, she writes, “this new fear of black men shamed me more than the rape.” Connors explains she didn’t want to be the stereotypical white woman of privilege, who clutches her purse and crosses the street when she sees a Black man walking her way. As a woman aware of her socioeconomic and racial privilege, she didn’t want to participate in oppression.

But it wasn’t just Black men that she feared—it was everything:

I turned my life into performance art. I acted normal, or as normal as I could manage, all the while living on my secret island of fear. As time went on, the list of my fears continued to grow. I was afraid of flying. Afraid of driving. Afraid of riding in a car while someone else drove. Afraid of driving over bridges. Afraid of elevators. Afraid of enclosed spaces. Afraid of the dark. Afraid of going into crowds. Afraid of being alone. Afraid, most of all, to let my children out of my sight.

From the outside, my performance worked. I looked and acted like most other mothers. Only I knew that my entire body vibrated with dread, poised to flee when necessary.

Years after her rape, Connors tells her children about it—both were born after the living nightmare in the theater and are college-aged by then—and begins to confront the fact that she has never “gotten over” it, even though she’s told countless therapists that she has. It is then, despite her husband’s protests and her own fears, that she decides that she must also confront her ignorance regarding her rapist and find him, just as he once threatened that he would find her.

Connors’ investigation is difficult, as she finds out almost at once that her rapist died in a prison hospital some years before. This, however, doesn’t stop her: She begins to investigate his family, trying to find anyone who may have known him and could explain, perhaps, why he did what he did.

Connors regards what she finds out about her rapist with empathy. Connors doesn’t forgive and forget—rather, she forgives, in a sense, by remembering, by finding others who remember, by dredging up a past that is as unpleasant for her interviewees as it is for her.

She eventually gets support from her newspaper to research and write her own story. At every one of the interviews, she expresses discomfort with what she’s doing and almost backs off. Pushed on by her photographer co-worker—and her own need to know—she continues on what has become a journalistic mission. Connors knows she is intruding into people’s lives and realizes she’s coming from a place of privilege, but ends up relating to so much of their stories that she finds her rage toward her rapist fizzling.

It’s with great care, too, that Connors treats the racial tensions that arise during her investigation. Connors talks to women of color who, in 2007 when she conducted her interviews, had never reported their rapes: “I know about rape,” one of Francis’ relatives says. “I was raped myself. Three times. But I asked for it because I was on drugs and I was prostituting.” Connors tells the woman that she didn’t ask for it or deserve it, but the woman tells her the story of how one of her rapes happened and concludes with: “And besides that […] he was a white guy.” This woman felt that nothing would be done about it, even if she did report it.

Connors also writes that in her case, she served as the “perfect witness”; she explains that her rape “isn’t [hers] at all. It’s the state’s, as in The State of Ohio v. David Francis.” The prosecutor tells her: “You’re the ideal witness,” because she is “a journalist, trained to observe details and remember them.” She adds:

I know what he really means. To him, I’m the perfect victim because I happen to fulfill just about all the requirements of a woman accusing a man of rape, going back before the Civil War. I am white, educated, and middle-class. I resisted, and I have a cut on my neck, bruises still healing on my spine, and a torn and blood-stained blouse to prove it. I immediately ran to report the rape.

Needless to say, David Francis is the perfect defendant: black, poor, and uneducated, with a criminal record.

In fact, as she finds out during her investigation, her assailant was both Black and Native American, and spent his youth in and out of juvenile detention, starting at age 12. Connors looks at the racial disparity in prisons, at the rate of poverty in the areas of Cleveland that she visits, at the way socioeconomic status and race are interwoven, how violence and drug abuse feed into those factors as well, and how sexual assault and abusive environments are so often passed down through generations. Connors discovered fellow survivors in her rapist’s family—his sister Laura, with whom Connors is still in touch, described her mother’s boyfriend raping her in a church. His entire family, she discovers, have been survivors of one kind or another.

Connors believes that her rapist was likely raped himself. During her assault, she had a clear feeling that Francis was re-enacting something done to him. And after learning that rape was common at the juvenile detention center where Francis did many stints, she assumes that he had been abused there and during his time spent locked up as an adult.

What is most striking about Connors’ book is not its bravery—though it is brave—or its shock value, which exists. The book is valuable because Connors recognizes and conveys to readers the cyclical nature of abuse, its pathological nature, and one of its sources: in David Francis’ case, perhaps learning by example.

News Law and Policy

Congressional Testimony: Anti-Choice Measure Would Turn People of Color Into ‘Suspects in the Exam Room’

Kanya D’Almeida

All of the letter’s 56 signatories are people of color who have had abortions. They say the bill would force providers to interrogate patients’ reasons for seeking care and “erect a political divide” between patients and their physicians.

Dozens of people of color sent a letter to Congress Thursday expressing outrage over the introduction of the Prenatal Nondiscrimination Act (PRENDA) of 2016 (HR 4924), which they say threatens the future of abortion care and codifies dangerous racist and sexist stereotypes against Asian American and Pacific Islanders, Black people, and Latinas.

Introduced by Rep. Trent Franks (R-AZ), chairman of the House Judiciary Subcommittee on the Constitution and Civil Justice, the bill seeks to impose criminal penalties on providers who perform abortions knowing that they are sought on the basis of the fetus’ race or sex.

It also seeks to criminalize anyone who coerces a person into seeking a race- or sex-selective abortion; anyone who raises funds for the procedure; or anyone who transports a woman into the United States or across state lines to obtain the abortion—and imposes a penalty ranging from a fine to a five-year prison term.

Cloaked in the language of “nondiscrimination,” the act would achieve the opposite goal, the letter says, by singling out women of color for additional scrutiny based on, among other things, the “gross mischaracterization” of Asian-American communities, in particular, as having a preference for male over female children.

This assumption, referred to in the bill as “son preference,” has no medical or empirical basis—as the letter points out, and as research has shown, birth sex ratios indicate that Asian American and Pacific Islander communities are having more girls on average than their white counterparts.

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All of the letter’s 56 signatories are people of color who have had abortions. They say the bill would force providers to interrogate patients’ reasons for seeking care and “erect a political divide” between patients and their physicians, essentially transforming abortion seekers of color into “suspects in the exam room.”

Signatories say they are deeply troubled by the bill’s racist language, which came to the fore at a recent House hearing during which anti-choice activists and other witnesses evoked a history of eugenics by way of supporting the bill, essentially equating women who choose abortion care to slave owners and white supremacists.

“Several people of color—including immigrant folks, queer folks, and Black folks—walked out of that hearing feeling disgusted by the way terrible stereotypes were used to twist our history, and then put into the congressional record,” Renee Bracey Sherman, one of the original drafters of the letter, said in an interview with Rewire.

“It was so deeply offensive to have to sit there and listen to people like Catherine Davis [of the anti-choice National Black Pro-Life Coalition] invoke the names of Black civil rights leaders like Dr. Martin Luther King and Rep. John Lewis (D-GA), saying, ‘They did not march across the Edmund Pettus Bridge so that Black women could have abortions.’”

She pointed out that King was a strong supporter of family planning, while Lewis has been an outspoken proponent of reproductive justice and abortion rights.

Bracey Sherman also said she was disturbed by the fact that Alveda King, a prominent figure in the anti-choice movement, was allowed to submit her testimony in a letter to Congress.

“I kept thinking, She doesn’t speak for me,” Bracey Sherman told Rewire. “I didn’t want her words to be the only ones representing people of color who’ve had abortions, because the overwhelming majority of us don’t regret our choices. I felt that we needed a voice too, we needed our testimony to be heard.”

Bracey Sherman, together with Kristine Kippins, who is the federal policy counsel for the U.S. Policy and Advocacy Program at the Center for Reproductive Rights, and Shivana Jorawar spent the weekend drafting the letter.

“This letter was very personal for me as a Black woman who has had an abortion,” Kippins told Rewire in a phone interview. “I’d never publicly said that I’d had an abortion, and this has really compelled me to speak out.”

She recalled the moment in last week’s hearing when Chairman Franks repeatedly silenced Miriam Yeung, the executive director of National Asian Pacific American Women’s Forum and the only pro-choice witness at the hearing.

“At one point Yeung said very quietly, ‘Black women choose abortion,’” Kippins said. “And I realized, she was talking about me. So I felt I had to stand up and say, ‘Yes, I am one of those women, I chose abortion and it was the best possible thing for me. I need people to trust me, and women like me, to make those decisions for ourselves,’” she added.

Her words echo the efforts of reproductive justice advocates like those in the Trust Black Women Partnership who have long fought to assert Black women’s bodily autonomy and push back against a wave of discriminatory laws that directly target or disproportionately impact Black women. These include a recent rash of anti-choice laws that impose medically unnecessary safety regulations on providers and force women to delay care by insisting on multiple medical appointments.

“If legislators actually care about women’s health they should work towards making abortion available to our community. They should vote the Women’s Health Protection Act, and the Equal Access to Abortion Coverage in Health Insurance (EACH Woman) Act into law,” Kippins stated.

“We need access to housing, job opportunities, education for the children we already have. Lawmakers need to stop wasting our time and taxpayers’ money with bills like this and start addressing the civil rights and economic needs of the Black community and our Asian and Latina sisters and brothers,” she said.

Race- and sex-selective abortion is not a widespread occurrence in the United States, but anti-choice groups and lawmakers have cited isolated studies claiming to document the practice occurring in immigrant communities as a way to push anti-abortion legislation in the past.

Drafters of the letter say the current proposed act echoes these same cultural and racial stereotypes, and represents a blatant attempt to control women’s bodies.

“As an Indo-Caribbean woman, I can think for myself—I don’t need oversight from misogynist and paternalist politicians,” Shivana Jorawar said in a phone interview with Rewire.

Jorawar had her abortion when she was in high school. She was 15 years old at the time, harboring dreams of becoming a lawyer and making her family proud.

“My parents were immigrants from Guyana. They came here with almost nothing to their name, and access to education was really an important part of their American dream,” Jorawar explained, adding that they sacrificed almost everything they had to pay for tuition and send her to the best possible schools, working minimum-wage jobs around the clock to do so.

“They uprooted themselves and crossed borders and oceans to get to this strange land only to be greeted by discrimination. So to me, in that moment when I found out I was pregnant, I just felt I could not let my family down by ruining my chances at academic success,” Jorawar said.

She had the abortion and went on to become the first lawyer in her family.

“Every time I see my parents beaming with pride when they introduce me to new people and say ‘My daughter is a lawyer,’ or every time a young woman in my community comes to me for mentorship, I’m reminded that I made the right decision for my life,” she told Rewire.

“So this suggestion that we can’t make our own decisions, that we are not people capable of having a vision for our lives, is just incredibly insulting and it needs to stop,” she said.